title: The Appearance Anxiety Inventory: validation of a process measure in the treatment of body dysmorphic disorder.
abstract: BACKGROUND
  At present there are no measures to identify the cognitive processes and behaviours that might mediate the outcome of treatment in people with Body Dysmorphic Disorder (BDD).
  
  
  OBJECTIVE
  To develop and validate a process measure that can be used to assess the progress of patients throughout therapy and in research for BDD.
  
  
  METHODS
  The psychometric properties of the Appearance Anxiety Inventory (AAI) were explored in a clinical group of participants diagnosed with BDD (Study 1) and in a non-clinical community group with high appearance concerns (Study 2). Item characteristics, reliability, and factor structure were analysed. Convergent validity with measures of related symptoms was assessed.
  
  
  RESULTS
  The AAI was found to have good test-retest reliability and convergent validity in the measurement of appearance anxiety. It was also sensitive to change during treatment. The scale was found to have a two-factor structure in the clinical group, with one factor characterized by avoidance, and a second factor comprised of threat monitoring. However, in the community sample it appeared to have a one-factor structure.
  
  
  CONCLUSIONS
  The results suggest that the AAI has the psychometric properties to determine whether changes in cognitive processes and behaviours can mediate the outcome following treatment in patients with BDD. This supports its potential usefulness in clinical and research settings.
authors.affiliation: Institute of Psychiatry,King's College London and South London and Maudsley NHS Foundation Trust,UK.
authors.forename: David
authors.initials: D
authors.lastname: Veale
authors.affiliation: Institute of Psychiatry,King's College London and South London and Maudsley NHS Foundation Trust,UK.
authors.forename: Ertimiss
authors.initials: E
authors.lastname: Eshkevari
authors.affiliation: Institute of Psychiatry,King's College London and South London and Maudsley NHS Foundation Trust,UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Kanakam
authors.affiliation: Institute of Psychiatry,King's College London and South London and Maudsley NHS Foundation Trust,UK.
authors.forename: Nell
authors.initials: N
authors.lastname: Ellison
authors.affiliation: Institute of Psychiatry,King's College London and South London and Maudsley NHS Foundation Trust,UK.
authors.forename: Ana
authors.initials: A
authors.lastname: Costa
authors.affiliation: Institute of Psychiatry,King's College London and South London and Maudsley NHS Foundation Trust,UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Werner
mesh_terms: D000293:Adolescent; D000328:Adult; D057215:Body Dysmorphic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D001828:Body Image; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013518:Surgery, Plastic / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult